This article has no abstract; the first 100 words appear below.
Presentation of Case
Dr. Jason E. Faris (Medicine): A 66-year-old woman was admitted to this hospital because of cardiac and renal failure.
The patient had been well until approximately 6 months earlier, when dyspnea on exertion and leg edema developed. A diagnosis of congestive heart failure was made at another facility. Two months before this evaluation, dyspnea worsened. The patient was admitted to the other hospital. An electrocardiogram (ECG) showed T-wave inversions in leads I and aVL. The serum level of urea nitrogen was 38 mg per deciliter (13.6 mmol per liter), and the level of creatinine was 1.9 mg . . .
This case was discussed at the Massachusetts General Hospital Cancer Center Grand Rounds.
Dr. Raje reports receiving consulting fees from Celgene, Novartis, and Amgen and grant support from AstraZeneca and Acetylon.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
No other potential conflict of interest relevant to this article was reported.
We thank Dr. Mandakolathur Murali for providing the images in Figure 1 in the Supplementary Appendix.
Source Information
From the Divisions of Hematology–Oncology (N.S.R.), Nephrology (D.J.R.S.), and Cardiology (A.M.J.), the Department of Medicine; and the Departments of Radiology (T.M.L.) and Pathology (A.R.S.), Massachusetts General Hospital; and the Departments of Medicine (N.S.R., D.J.R.S., A.M.J.), Radiology (T.M.L.), and Pathology (A.R.S.), Harvard Medical School — both in Boston.
HEPATITIS-B-VACCINES
CKD-Micro1
CKD Algorithm